{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  AICIRTAPRELTUB C ","gend":1,"add":"AMTORT 5033RD FRAHW N","city":"SUFFOLK","state":"VA","zip":"23435-9998","dob":"1946-07-01","age":"","mstatus":"","insh":"89300210*89","cliId":"","pno":"62\/7578061-9","cno":"757\/337-9997","email":"","ename":"","eno":"","pphy":"HILLS, LISA M NP","ppno":"757\/483-6401","pcpadd":"STE K 4053 TAYLOR ROAD","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":23321,"pcpcounty":"","pcpid":"","pcpname":"FIRST CARE PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C48.0","Z51.11","J96.01","J18.9","C56.9","E87.1","J96.91","R79.89","C78.6","M10.9","E78.00","D70.3","Z20.828","R05.","Z23.","Z51.12","R91.8","R09.02","E86.0","R63.4","H04.123","H04.121","H04.122","Z71.9","D64.81","G64.","I82.C11","R19.7","J20.8","J45.20","J30.9","R05.9","D70.1","T82.9XXA","Z68.21","B37.3","A41.9","J69.0","J96.21","J12.9","I31.3","D84.9","J44.0","R65.20","Z20.822","K21.9","Z89.611","NO DATA","Z87.891","C80.1","I82.890","Z45.2","H20.042","Z86.718","J44.9","M89.9","H57.051","L21.0","L65.9"],"date":["2021-12-15","2021-11-24","2021-12-19","2021-12-19","2021-12-19","2021-12-19","2021-12-20","2020-10-26","2021-12-15","2021-12-15","2021-12-15","2021-10-01","2021-12-01","2021-07-26","2021-10-01","2021-11-24","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2021-10-25","2020-02-25","2020-02-25","2021-12-14","2020-07-15","2020-12-09","2020-07-15","2020-12-09","2021-07-26","2021-12-14","2021-07-26","2021-12-14","2020-04-15","2020-12-17","2021-03-03","2021-05-05","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2021-12-15","2019-07-15","2019-06-27","2019-08-06","2019-11-22","2019-06-27","2019-10-14","2019-10-14","2019-02-25","2019-12-30","2019-12-30"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","","FLUCONAZOLE"," FLUCONAZOLE ","3","Select","Select",""],["","","ALLOPURINOL"," ALLOPURINOL ","30","Select","Select",""],["","","CETIRIZINE"," CETIRIZINE ","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","","MONTELUKAST"," MONTELUKAST ","30","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","90","Select","Select",""],["","49884029001","MEGESTROL","TAB 40MG","96","Select","Select",""],["","00173088710","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","15","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","","DEXAMETHASON","TAB 4MG","","Select","Select",""],["","","ADVAIR"," ADVAIR ","60","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","","FLUTIC\/SALME"," FLUTIC\/SALME ","60","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","0",""," ","480","Select","Select",""],["","66685100101","AMOX\/K","TAB 875-125","14","Select","Select",""],["","00173085910","BREO","INH 100-25","60","Select","Select",""],["","","PANTOPRAZOLE"," PANTOPRAZOLE ","30","Select","Select",""],["","","PROCHLORPER","TAB 10MG","","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00054001925","PREDNISONE","TAB 50MG","5","Select","Select",""],["","00023040330","REFRESH","DRO 0.5% OP","30","Select","Select",""],["","","ALLERGY"," ALLERGY ","90","Select","Select",""],["","","RUBRACA","TAB 300MG","","Select","Select",""],["","","XARELTO"," XARELTO ","30","Select","Select",""],["","","SIMVASTATIN"," SIMVASTATIN ","30","Select","Select",""],["","","3"," 3","21","Select","Select",""],["","","NEO\/POLY\/DEX"," NEO\/POLY\/DEX ","5","Select","Select",""],["","","KETOCONAZOLE"," KETOCONAZOLE ","120","Select","Select",""],["","","ONDANSETRON","TAB 8MG ODT","","Select","Select",""],["","","CIPROFLOXACN","TAB 500MG","","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}